Ultrasonic endoluminal examination in the follow-up of colorectal cancer. Initial experience and results.
We have been using endoluminal ultrasonography since 1988 as part of the follow-up procedure after colorectal surgery. A total of 106 patients with anterior resection of the rectum or the sigmoid colon were involved in 1988. The follow-up period for these patients ranged from 1 to 56 months after surgery (23.1 +/- 15.1 months after anterior resection of the rectum; 25.7 +/- 22 months after anterior resection of the sigmoid). During the observation period 7 patients developed recurrence after anterior resection of the rectum and 5 after anterior resection of the sigmoid. The primary stages for these patients had been 7 cases of Dukes' B, 3 of Dukes' C1 and 2 of Dukes' D. Raised serum CEA levels were found in 5 cases. In 3 other cases, we found pathological changes in the anastomotic region by means of endoscopy. In these the endorectal ultrasonic scan showed hypodense masses as a sign of recurrence. In 2 of these 3 cases, the serum CEA level was normal. In 4 cases endoluminal rectal ultrasonography alone was suspicious. This led to further diagnostic procedures and finally to radical excision. All suspicious ultrasonic images were monitored 2 to 4 weeks later. In cases of suspicion, endoscopic, needle or surgical transrectal biopsies were taken from all patients. In all cases, histological analysis confirmed the ultrasonic diagnosis of local recurrence.
Dresing
K
K
Surgical Department, Marien-Hospital Düsseldorf, Federal Republic of Germany.
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D000368:Aged; D002272:Carcinoembryonic Antigen / Q000097:blood; D003106:Colon / Q000000981:diagnostic imaging* / Q000473:pathology; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology; D009367:Neoplasm Staging; D012007:Rectum / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography
D002272:Carcinoembryonic Antigen